Long term risk of severe retinopathy in childhood-onset type 1 diabetes: a data linkage study

The known Microvascular complications in people with type 1 diabetes mellitus are directly related to glycaemic control.

The new This is the first study to assess the risk of complications in people with type 1 diabetes according to their glycaemic control trajectory between childhood and adulthood. Severe diabetic retinopathy (SDR) was associated with higher paediatric HbA1c levels, independent of glycaemic control during adulthood. Importantly, SDR was not documented in patients with a stable low glycaemic control trajectory.

The implications Target-based treatment from the time of diagnosis of type 1 diabetes in childhood is required to reduce the risk of SDR during adulthood.

Whether microvascular complications develop in people with type 1 diabetes mellitus is critically dependent on their glycaemic control.1–3 In the large Diabetes Control and Complications Trial (DCCT) and the Epidemiology of Diabetes Complications (EDIC) trial, however, mean glycated haemoglobin A1c (HbA1c) levels could only be estimated from data acquired at trial entry; consequently, the effect of the cumulative glycaemic…